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brand viagra 50mg online Ture cytotoxin assay, which detects toxin b from stool filtrate, is considered the gold standard because of its high sensitivity and specificity. cheap viagra viagra for sale cheap viagra online cheap generic viagra cheap viagra online cheap viagra online cheap generic viagra buy generic viagra viagra online buy cheap viagra 2 the disadvantages are its need for 24 to 48 hours for completion, as well as requiring tissue culture capability. The most common test used to establish a diagnosis of c. Difficile is an enzyme-linked immunosorbent assay (elisa) for toxin a or toxins a and b. 18 the elisa test is less technically demanding as compared with the cytotoxin assay. Although not as sensitive as the gold standard, the test performs well and has been widely adopted by clinical microbiology laboratories. Repeated testing may improve its sensitivity, although one specimen should usually be sufficient for diagnosis. 6 although inexpensive and easy to perform, a latex agglutination test for glutamate dehydrogenase, or common antigen, which is an enzyme-produced in clostridium spp. As well as other bacteria, is not recommended for use in c. Difficile diagnosis. This is because of its low poor sensitivity and specificity compared with other available testing strategies. 6 stool culture for c. Difficile is rarely performed in clinical microbiology laboratories because of inconvenience compared with other marketed tests. Culture is very sensitive but not specific, because it will not distinguish between toxigenic and nontoxigenic strains. 6 this question can be answered if a toxin assay is added as a second step in the test. The benefits of stool culture include the ability to perform epidemiologic investigations and strain typing of isolates. The polymerase chain reaction (pcr) assay for c. Difficile toxins is currently a research method that shows promise as a more sensitive and specific test as compared with elisa, with results similar to those of cytotoxin assays. 2 its use in the clinical setting may be limited because of its cost compared with elisa. 16 endoscopy should be considered when a rapid diagnosis is required, the patient has an ileus and stool is unable to be obtained, and other colonic diseases are being considered, such as inflammatory bowel disease. 6 sigmoidoscopy or colonoscopy is required to visualize the colonic mucosa to establish the diagnosis of pseudomembranous colitis. Pseudomembranes are 2- to 10-mm raised yellow plaques that may have areas of normal mucosa or may coalesce to form larger plaques. Flexible sigmoidoscopy can miss up to 10% of cases of pseudomembranous colitis. If pseudome.